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Predictors of Cognitive Decline After Chemotherapy in Breast Cancer Patients

Published online by Cambridge University Press:  01 November 2009

KATHARINE J. VEARNCOMBE ,
MARGARET ROLFE ,
MARGARET WRIGHT ,
NANCY A. PACHANA ,
BROOKE ANDREW  and
GEOFFREY BEADLE
KATHARINE J. VEARNCOMBE*
Affiliation:
The University of Queensland, School of Psychology, Brisbane, Australia The Wesley Research Institute, Wesley Hospital, Brisbane, Australia
MARGARET ROLFE
Affiliation:
Graduate Research College, Southern Cross University, Lismore, Australia School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
MARGARET WRIGHT
Affiliation:
Queensland Institute of Medical Research, Brisbane, Australia
NANCY A. PACHANA
Affiliation:
The University of Queensland, School of Psychology, Brisbane, Australia
BROOKE ANDREW
Affiliation:
The University of Queensland, School of Psychology, Brisbane, Australia The Wesley Research Institute, Wesley Hospital, Brisbane, Australia
GEOFFREY BEADLE
Affiliation:
Queensland Institute of Medical Research, Brisbane, Australia
*
*Correspondence and reprint requests to: Katharine J. Vearncombe, School of Psychology, University of Queensland, St Lucia Brisbane, Australia. E-mail: k.vearncombe@psy.uq.edu.au
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Abstract

The objective of this study is to identify whether decline in cognitive functioning after chemotherapy in women with breast cancer is associated with health/disease, treatment, and psychological variables. Neuropsychological performance, health/disease, and treatment-related information of 136 women with breast cancer (age M = 49.38; SD = 7.92; range = 25.25–67.92) was assessed pre-chemotherapy and 1-month post-chemotherapy. The Reliable Change Index corrected for practice (RCIp) identified women whose performance significantly declined, while Pearson correlations assessed the relationship between cognitive change and predictor variables. A total of 16.9% of women showed significant decline post-chemotherapy, with affected domains including verbal learning and memory, abstract reasoning, and motor coordination. Decline in hemoglobin levels and increased anxiety over the course of chemotherapy was found to significantly predict impairment in multiple cognitive measures. Change in specific cognitive measures was significantly associated with baseline fatigue, depression, and functional well-being (r = 0.23 to 0.33; p = .01 to < .001). Although the effects are small, there is evidence that psychological and health factors may increase vulnerability to cognitive dysfunction after chemotherapy for breast cancer. Significant associations reported in this study may be useful in the identification and treatment of at-risk individuals. (JINS, 2009, 15, 951–962.)

Keywords

Adjuvant chemotherapyBreast cancerCognitive domainsCognitive impairmentNeurotoxicityMemory
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 6 , November 2009 , pp. 951 - 962
Copyright
Copyright © The International Neuropsychological Society 2009

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